Treatment of Posterior Cruciate Ligament Tibial Avulsion Fractures Through a Modified Open Posterior Approach: Operative Technique and 12- to 48-Month Outcomes

Abstract

Treatment of tibial PCL avulsion fractures, which includes fixation through a modified open posterior approach and early postoperative range of motion, results in healing of the fracture, good functional outcomes, stability to posterior draw testing, and does not lead to gastrocnemius weakness or significant range of motion deficits at 12 to 48 months postoperatively.

Midterm results of open reduction and internal fixation of isolated posterior cruciate ligament avulsion fracture

“…Several open [4,[8][9][10][11][12][13][14] and arthroscopic techniques [5,[14][15][16][17][18][19][20] have been described. Although arthroscopic surgical fixation is more popular nowadays, but open reduction under direct vision still is an acceptable procedure due to its safety, facility, direct visualization of the fracture site, and perfect anatomic reduction.…”

Effects of microendoscopy-assisted reduction and screw fixation through a single mini-incision on posterior cruciate ligament tibial avulsion fracture

“…In our approach, loose fatty tissue is isolated along the lateral border of the medial head of the gastrocnemius so that the popliteal neurovascular bundle can be protected by those loose tissues. It is very convenient to approach the posterior knee joint capsule and the attachment of the PCL without the neurovascular bundle revealed [14]. Direct separation and stretching of the major vessels and nerves could be avoided during the operation, which alleviated postoperative adhesions and joint rigidity and promoted functional recovery without complications of any major vessels and nerves.…”

Arthroscopic-Assisted Reduction and Fixation of a Posterior Cruciate Ligament Avulsion Using Endobutton

“…Some approaches modified this further but may have included osteotomies of the fibula neck [13,14,15]. Immobilisation of the lower limb was also common place resulting in stiffness and suboptimal results [16,17,18]. The use of functional or range of movement (ROM) brace allowed acceleration of the rehabilitation phase.…”